JOAN K SHORT MD
Controlled Substance Registration for Practitioner


Address: 6301 Kennett Pike, Wilmington, DE 19807

JOAN K SHORT MD (Credential# 341885) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2006. The license expiration date date is February 28, 2007. The license status is INACTIVE.

Business Overview

JOAN K SHORT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0033718. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2006. The expiration date is February 28, 2007. The business address is 6301 Kennett Pike, Wilmington, DE 19807. The current status is inactive.

Basic Information

Licensee Name JOAN K SHORT MD
Credential ID 341885
Credential Number CSP.0033718
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 6301 Kennett Pike
Wilmington
DE 19807
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2006-03-01
Expiration Date 2007-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
559209 1.041626 Physician/Surgeon 2003-07-02 2004-04-05 - 2005-05-31 INACTIVE

Office Location

Street Address 6301 KENNETT PIKE
City WILMINGTON
State DE
Zip Code 19807

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Competitor

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City WILMINGTON
Zip Code 19807
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WILMINGTON

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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